Consumer, quality care and leadership

The primary purpose of facilities and the aged care sector is to provide quality care to residents; however, different levels of quality are observed with no uniform practice present amongst providers above the minimum hurdle of regulated accreditation standards. 

Unfortunately, some facilities may forget that whilst the government subsidises large financial contributions to their businesses, it’s the consumer’s’ occupation of a bed in their facility that triggers their entitlement to this subsidy. 

The awareness of who the real customer is, or by way of lack of consequence or alternative, is not yet sufficient to result in change.

Physical vs experiential comparisons

Information about quality of care is often mistaken for quality aesthetics, fixtures and fittings (such as chandeliers and chaise lounge suites). 

The physical elements of an aged care facility, whilst important, are no substitute for quality of care such as the service or hands on care provided. 

Which generally are those more subjective factors such as: food quality, care delivered by skilled nursing and clinical staff, prompt attention when needed, the right to have their say and be heard. 

These quality factors are a true testament to the care delivered from the residents satisfaction that are too frequently ignored or simply never asked. 

One perspective is that the absence of this information and quality of care benchmarks is not to imply that providers do not care about their residents. 

Instead, likely due to the fact that providing accurate and persuasive information about the quality of care and subjective experiences is significantly more complex than objective physical characteristics. 

As well as to a degree the market hasn’t yet demanded it. 

In short, there has been little economic incentive to value subjective feedback around quality of care, as beds are filled without investment required in improving this aspect of a provider’s business and government accreditation does not require a comprehensive test of these factors either.

Without this demand, it is left to facility leadership to implement a quality of excellence to set their own ‘standard’. 

Good leadership can lead to providers excelling and exceeding the accreditation standards elevating the quality of service by investing in quality care. 

However, if there is not strong consistent leadership support and a culture of seeking excellence across the organisation then strategic interventions to create positive change are unlikely to succeed because, put simply, they aren’t required to do so. 

The distressing consequence of these scenarios can be failure to focus on excellence in care in these scenarios by leadership manifesting in unfocused or insufficiently resourced direct care staff and sadly, on unsatisfactory treatment of the vulnerable residents in their care.

So until there is demand or requirement otherwise, and whilst there continues to be an industry shortage of beds, what motivation does the industry have to  provide excellent quality, and invest in better care? 

Particularly when their beds will be filled and their bills paid through subsidies, regardless, in some ways, of the quality of the residents’ experiences as long as they satisfy minimum accreditation standards. 

This is a structural issue in the industry that is slowly changing but accelerating now through digitisation.

To improve the quality and standard of care provided, the focus needs to be on what residents, their families and employees have to say whether publicly or privately; after all, they are the eyes and the ears, or recipients of the care, and the ones best positioned to understand and define the differences between unacceptable and excellent quality care. 

This is not about whistleblowing for isolated cases, quite the opposite, it’s about showcasing excellence, supporting underperformers and driving gradual sustainable reform by peers influencing improvements positively through competition where policy based reform cannot succeed alone. 

The private sector and marketplace through competition has to play this role in change by listening to the consumer. 

There will come a time when a simple supply constraint on beds does not ensure a bed is filled for all the providers in the marketplace.

Providing consumers with choice and engaging with them to ensure their views and preferences are part of the decision-making process, however, this must go beyond the existing ‘compliments and complaints’ form. 

Regular engagement with stakeholders and the elevation of the consumer experience will ensure providers are able to deliver resident-centred quality care based on what residents actually want. 

Rather than the provider simply meeting what the resident in accordance with the government Accreditation is defined to want. 

The problem with the current system, despite best intentions and due to a supply-constrained market place still protects facilities that try but miss the mark by a small or wide margin of what’s truly acceptable by filling their beds anyway, protecting their government driven income and providing no incentive to improve or change. In any event, simply meeting the minimum standard hurdles set by accreditation requirements will never create the required changes. 

An honest broker, a marketplace of integrity and an open transparent competition environment all play a critical role in achieving change. 

The marketplace is evolving and the independence and integrity will be critical to win the trust of the consumer and the facility providers alike and to allow such an evolution in consumer driven competition to flourish.

CarePage is a site established to compare quality nursing homes and showcase excellence in care as a starting point is the first step to truly being consumer focused when it comes to residential aged care. 

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